NR572 Exam 1 Actual Exam Style V1 | NR
572 Advanced Acute Care Management |
Chamberlain
1. Which clinical finding is most characteristic of left-sided heart failure?
A. Jugular venous distention
B. Hepatomegaly
C. Peripheral edema
D. Pulmonary crackles
Correct Answer: D
Expert Explanation: Left-sided heart failure occurs when the left ventricle fails to pump
blood efficiently into the systemic circulation. This failure causes blood to back up into the
lungs, leading to pulmonary congestion and crackles. Right-sided heart failure typically
presents with systemic symptoms like edema and jugular venous distention.
2. In the initial management of septic shock, what is the recommended volume for crystalloid
resuscitation?
A. 10 mL/kg
B. 30 mL/kg
C. 20 mL/kg
D. 50 mL/kg
,Correct Answer: B
Expert Explanation: The Surviving Sepsis Campaign guidelines recommend an initial fluid
bolus of at least 30 mL/kg of intravenous crystalloid. This fluid challenge should be
completed within the first three hours of identifying sepsis-induced hypoperfusion.
Monitoring the patient’s hemodynamic response is essential to determine if further fluids
are necessary.
3. Which laboratory marker is the most specific for diagnosing an acute myocardial
infarction?
A. Creatine kinase (CK-MB)
B. Myoglobin
C. Troponin I or T
D. Lactate dehydrogenase
Correct Answer: C
Expert Explanation: Troponins are regulatory proteins in cardiac muscle that are released
into the bloodstream when myocardial cells are damaged. They are highly sensitive and
specific to cardiac tissue injury compared to other markers like CK-MB. Elevated troponin
levels are a primary criterion for diagnosing acute myocardial infarction in the clinical
setting.
, 4. What is the primary difference between hypertensive urgency and hypertensive
emergency?
A. The absolute blood pressure reading
B. The age of the patient
C. The presence of acute end-organ damage
D. The history of chronic hypertension
Correct Answer: C
Expert Explanation: Hypertensive emergency is defined by severely elevated blood
pressure accompanied by signs of acute target organ damage, such as encephalopathy or
acute kidney injury. Hypertensive urgency involves high blood pressure without evidence
of immediate organ dysfunction. Managing an emergency requires rapid, intravenous
medication, whereas urgency is often managed with oral agents over a longer period.
5. A patient with an acute COPD exacerbation is most likely to show which acid-base
imbalance on an ABG?
A. Respiratory acidosis
B. Metabolic alkalosis
C. Metabolic acidosis
D. Respiratory alkalosis
Correct Answer: A
572 Advanced Acute Care Management |
Chamberlain
1. Which clinical finding is most characteristic of left-sided heart failure?
A. Jugular venous distention
B. Hepatomegaly
C. Peripheral edema
D. Pulmonary crackles
Correct Answer: D
Expert Explanation: Left-sided heart failure occurs when the left ventricle fails to pump
blood efficiently into the systemic circulation. This failure causes blood to back up into the
lungs, leading to pulmonary congestion and crackles. Right-sided heart failure typically
presents with systemic symptoms like edema and jugular venous distention.
2. In the initial management of septic shock, what is the recommended volume for crystalloid
resuscitation?
A. 10 mL/kg
B. 30 mL/kg
C. 20 mL/kg
D. 50 mL/kg
,Correct Answer: B
Expert Explanation: The Surviving Sepsis Campaign guidelines recommend an initial fluid
bolus of at least 30 mL/kg of intravenous crystalloid. This fluid challenge should be
completed within the first three hours of identifying sepsis-induced hypoperfusion.
Monitoring the patient’s hemodynamic response is essential to determine if further fluids
are necessary.
3. Which laboratory marker is the most specific for diagnosing an acute myocardial
infarction?
A. Creatine kinase (CK-MB)
B. Myoglobin
C. Troponin I or T
D. Lactate dehydrogenase
Correct Answer: C
Expert Explanation: Troponins are regulatory proteins in cardiac muscle that are released
into the bloodstream when myocardial cells are damaged. They are highly sensitive and
specific to cardiac tissue injury compared to other markers like CK-MB. Elevated troponin
levels are a primary criterion for diagnosing acute myocardial infarction in the clinical
setting.
, 4. What is the primary difference between hypertensive urgency and hypertensive
emergency?
A. The absolute blood pressure reading
B. The age of the patient
C. The presence of acute end-organ damage
D. The history of chronic hypertension
Correct Answer: C
Expert Explanation: Hypertensive emergency is defined by severely elevated blood
pressure accompanied by signs of acute target organ damage, such as encephalopathy or
acute kidney injury. Hypertensive urgency involves high blood pressure without evidence
of immediate organ dysfunction. Managing an emergency requires rapid, intravenous
medication, whereas urgency is often managed with oral agents over a longer period.
5. A patient with an acute COPD exacerbation is most likely to show which acid-base
imbalance on an ABG?
A. Respiratory acidosis
B. Metabolic alkalosis
C. Metabolic acidosis
D. Respiratory alkalosis
Correct Answer: A
